Alterations of blood pressure in type 1 diabetic children and adolescents

Darcan, Şükran; Gökşen, Damla; Mır, Sevgı; Serdaroğlu, Erkin; Buyukınan, Muammer; Çöker, Mahmut; Berdeli, Afig; Köse, Timur; Cura, Alphan

doi:10.1007/s00467-006-0074-x

Cited by 50 publications

(40 citation statements)

References 23 publications

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“…This supports our hypothesis that rises in ACR, even within the normal range, may parallel similar progressive increases in ABP. The associations between ACR and ABP at baseline were not explained by HbA 1c or BMI, although both these factors were independent contributors of ABP, in line with the findings of previous studies [24,30,31]. Similarly, SBP and DBP were independently associated with future changes in ACR during the subsequent follow-up period.…”

Section: Discussionsupporting

confidence: 89%

Ambulatory blood pressure measurements are related to albumin excretion and are predictive for risk of microalbuminuria in young people with type 1 diabetes

et al. 2009

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Aims/hypothesis The relationship between BP and microalbuminuria in young people with type 1 diabetes is not completely clear. As microalbuminuria is preceded by a gradual rise in albumin excretion within the normal range, we hypothesised that ambulatory BP (ABP) may be closely related to albumin excretion and progression to microalbuminuria. Results All ABPM variables were significantly related to baseline log 10 ACR (p<0.001). After the ABPM evaluation, 287 patients were followed for a median of 2.2 (1.0-5.5) years. ABP at baseline was independently related to mean ACR during follow-up. Nineteen initially normoalbuminuric patients developed microalbuminuria after 2.0 (0.2-4.0) years and their baseline daytime DBP was higher than in normoalbuminuric patients (p<0.001). After adjusting for baseline ACR and HbA 1c , there was an 11% increased risk of microalbuminuria for each 1 mmHg increase in daytime DBP. Forty-eight per cent of patients were non-dippers for SBP and 60% for DBP; however, ACR was not different between dippers and non-dippers and there were no differences in the nocturnal fall in BP between normoalbuminuric and future microalbuminuric patients. Conclusions/interpretation In this cohort of young people with type 1 diabetes, ABP was significantly related to ACR, and daytime DBP was independently associated with progression to microalbuminuria. Increasing albumin excretion, even in the normal range, may be associated with parallel rises in BP. Methods

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Section: Discussionsupporting

confidence: 89%

Ambulatory blood pressure measurements are related to albumin excretion and are predictive for risk of microalbuminuria in young people with type 1 diabetes

et al. 2009

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“…The existence of an association between greater pressure loads and increased UAE was demonstrated in patients with DM Type 1 44,45 and Type 2 13 . Recently, correlations between pressure loads and UAE, left ventricular mass, interventricular thickness, and left posterior ventricular wall in Type 2 DM patients 41 were demonstrated by our group.…”

Section: Pressure Loads and Diabetes Mellitusmentioning

confidence: 90%

Monitorização ambulatorial da pressão arterial e diabete melito tipo 2

Leitão¹,

Canani²,

Silveiro³

et al. 2007

Arq. Bras. Cardiol.

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SummaryHypertension is one of the main risk factors for the onset and progression of chronic complications in type 2 diabetes mellitus (DM).Ambulatory blood pressure (BP) monitoring (ABPM) provides a better correlation with target organ lesions than BP obtained in the office. Furthermore, it allows the evaluation of distinct BP parameters such as the 24-h, daytime and nighttime systolic and diastolic BP means, BP loads and the absence of nocturnal drop of BP, as well as the identification of white-coat and masked hypertension.DM patients have higher daytime and nighttime BP means than non-DM patients. In addition, one third of normotensive type 2 DM patients have masked hypertension, which is associated with an increase in albuminuria and in left ventricle wall thickness. On the other hand, the prevalence and effect of white-coat hypertension in type 2 DM patients have not yet been properly evaluated. The absence of nocturnal drop of BP does not add information to the 24 h, daytime or nighttime BP measurements, but the nighttime BP means seem to be relevant in DM retinopathy.In conclusion, BP determination by ABPM allows better patient risk stratification for the development of DM chronic complications and is an essential instrument for effective BP control in these patients. Arterial pressure and diabetes mellitusType 2 diabetes mellitus (DM) is associated with the development of chronic microvascular and macrovascular complications with high rates of morbidity and mortality 1,2 . The classic and most analyzed risk factors for the development and progression of chronic DM complications are DM duration, hyperglycemia, arterial hypertension (AH), dyslipidemia, and smoking, besides genetic factors [3][4][5][6][7][8] . The treatment of hyperglycemia and SAH results in primary prevention and reduction of the progression of diabetic retinopathy (DR) and diabetic nephropathy (DN) 9,10

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“…9 Dalam sejarah hipertensi diyakini bahwa tekanan darah diastolik yang paling penting, namun kemudian secara umum diterima bahwa sistolik merupakan alat prediksi yang lebih baik untuk tujuan pengobatan. Menurut Darkan dkk, 10 pasien DM dengan mikroalbuminuria memiliki tekanan darah diastolik yang lebih tinggi dibandingkan pasien normoalbuminuria, tetapi tidak ada perbedaan tekanan sistolik dan diastolik antara kelompok normoalbuminuria dan mikroalbuminuria. Tekanan diastolik menunjukkan hubungan dengan lama diabetes, rata-rata HbA1c, dan tingkat mikroalbuminuria.…”

Section: Pembahasanunclassified

“…Usia saat diagnosis ditegakkan, kadar HbA1c, dan lama sakit secara umum tidak mempunyai perbedaan. Hal tersebut berbeda dengan laporan Darkan dkk 10 yang melakukan pengukuran tekanan darah siang dan malam, maka dianjurkan dilakukan pengukuran tekanan darah dilakukan secara serial. Pada penelitian oleh Darkan dkk didapatkan hubungan bermakna antara hipertensi dengan mikroalbumin dibandingkan dengan normoalbumin (54 versus 17,54%; p=0,05).…”

Section: Pembahasanunclassified